Author Jeff Tsai
This is the first entry in an ongoing series for ‘MMA Strategy’ that will focus on sports medicine. The objective of this series is to combine medical research with combat sports to provide insight into MMA strategy. This series will look at hot topics in the MMA world like training techniques, injuries, and nutrition, and analyze how they give fighters an added edge or put them at a disadvantage.
UFC 104 – Machida vs. Shogun October 24, 2009
In his last two bouts leading up to this championship match, Shogun has looked alternately sloppy and then sharp. Is he still feeling the effects of his knee injuries or is he back to being the dominant powerhouse of his Pride days?
We’re going to investigate the nature of a torn ACL, the time course for healing, and the implications the injury has for each fighter in their upcoming fight.
On to the diagnosis!
The Patient: Mauricio “Shogun” Rua
Injury: Torn anterior cruciate ligament (ACL) in left knee
Patient History:
2005 - Shogun was at the top of his game, winning Pride’s middleweight Grand Prix and arguably the top ranked 205-pound fighter in the world.
2006 - Even a freak injury in a bout against Mark Coleman couldn’t derail his train of destruction. Shogun went on to win four straight matches after that anomalous loss. His subsequent signing into the UFC brought expectations that his crowning as light-heavyweight champion would be a mere formality.
September 2007 - At UFC 76, Forrest Griffin shocked many by submitting a sluggish Shogun. His poor performance was discovered to be the result of a knee-ligament injury sustained during training that was re-injured during the fight.
October 2007 – Shogun successfully underwent surgery to repair the torn ACL in his left knee
March 2008 – While training for a June bout against Chuck Liddell, Shogun ruptured the ACL in his left knee again. He successfully underwent knee reconstruction surgery to repair the ACL.
January 2009 – Shogun returned to the Octagon and defeated 44-year old Mark Coleman in a mediocre performance.
April 2009 – Shogun KO’d Chuck Liddell with a lunging left hook.
October 2009 – Shogun vs. Lyoto Machida for the LHW belt.
Medical Background: The ACL is one of four ligaments whose primary function is to stabilize the knee joint. Ligaments connect bones to other bones and are composed of fibrous tissue, which doesn’t have its own blood supply, thus limiting its ability to heal and self-repair. Untreated, the two ends of the torn ligaments never reconnect. Torn ACLs cause damage to knee cartilage, which are soft pads that act as shock absorbers to prevent bone-to-bone contact. Degradation of knee cartilage can result in pain and arthritis, especially when weight is applied to the injured leg.
Current ACL reconstruction surgery techniques can preserve the cartilage and restore the attachment sites of the ligaments, retaining much of the original biomechanical function and neuromotor control. With physical therapy and rehabilitation, a patient can return to previous levels of activity in 6-9 months. Despite these medical advances, some athletes in high intensity sports don’t regain their previous form and approximately 20% of those that underwent reconstructive surgery report knee instability. The ACL is at greatest risk of re-injury during hyperextension of the knee, as well as quick, cutting motions that involve acceleration and deceleration.
MMA Diagnosis: Shogun’s lackluster performance against Coleman came 10 months after knee surgery, which is just over the standard duration of healing for an ACL injury. This certainly affected his training camp and his diminished cardio. This was reflected in his clear imitation of Fat Albert after running up a flight of stairs.
Shogun’s showdown with Machida will come 19 months after his 2nd operation, which is plenty of time for rehabilitation and conditioning. His cardio, or previous lack thereof, won’t likely be as big a factor until the later championship rounds. The stability of his knee is the big question mark. Shogun should avoid performing any kicks with his left leg, because extension at the knee joint puts a high amount of strain on the ACL. He’ll have to be cautious with the level of his right roundhouse kicks because extension and locking of his left planted leg increases with the height of his kick. From the standpoint of reducing his injury probability and controlling the speed and tempo of the fight, Shogun’s best strategy would be to close the distance with Machida and unleash a barrage of Muay Thai strikes in the clinch.
Machida can best exploit Shogun’s injury by utilizing kicks to Shogun’s lead leg to test the stability of his left knee. Throwing feints in both directions is another good strategy because lateral movements that force Shogun to quickly start and stop will put undue stress on the joint. Circling to his left (Shogun’s right) will help Machida avoid the left hook that iced Liddell while additionally increasing Shogun’s inward knee torque, another high stress action.
It’s certainly possible that Shogun has completely healed from his knee injury and no longer suffers any lingering effects. However, it’s also feasible that he’ll never fully regain the form and function of his glorious soccer-kicks-to-the-head days. In a sport where one misstep is the difference between becoming a champion and being removed on a stretcher, a little knowledge may just be the prescription for victory.
About the Author:
Jeff is not a doctor or King of Pancrase, but his educational background and physical training have made him uniquely positioned to intelligently discuss the subject matter. Jeff has a degree in Biochemistry from UC San Diego and is currently pursuing a Master’s of Science in Kinesiology and Exercise Physiology. Jeff has also earned a black belt in Shorin-Ryu Karate and dabbled in BJJ and boxing training. One of his real passions is discussing and analyzing the real fighters.
References:
Frank CB, Jackson DW. Current Concepts Review - The Science of Reconstruction of the Anterior Cruciate Ligament. The Journal of Bone and Joint Surgery. 1997, 79:1556-76
Jung HJ, Fisher MB, Woo SL. Role of biomechanics in the understanding of normal, injured, and healing ligaments and tendons. Sports Med Arthrosc Rehabil Ther Technol. 2009, May 20;1(1):9.
Killian ML, Isaac DI, Haut RC, Déjardin LM, Leetun D, Haut Donahue TL. Traumatic Anterior Cruciate Ligament Tear and its Implications on Meniscal Degradation: A Preliminary Novel Lapine Osteoarthritis Model. J Surg Res. 2009, Apr 5. [Epub ahead of print]
Murray MM. Current status and potential of primary ACL repair. Clin Sports Med. 2009, Jan;28(1):51-61.
http://en.wikipedia.org/wiki/
http://mmafrenzy.com/1273/
http://mmafrenzy.com/1315/
http://mmafrenzy.com/2070/rua-
http://mmafrenzy.com/2205/
http://www.mayoclinic.com/
http://www.sherdog.com/
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Yeah! Shogun had it tough during his early years as an MMA fighter. But he did bounce back after rehabilitating his torn ACL, one of the most serious injuries an athlete can ever have. He certainly showed heart and commitment throughout his rehab. I can't wait to watch his upcoming fights! His last battle with Dan Henderson was absolutely epic!
ReplyDeleteStephen Schaunt